Foot and Ankle Surgery最新文献

{"title":"Minimally invasive surgical treatments versus non-surgical treatments or placebo for plantar fasciopathy: A systematic review.","authors":"Stefan Møller, Jonas Ammundsen Ipsen, Henriette Jahn Aunass, Per Aagaard, Bjarke Viberg, Ane Simony, Henrik Riel","doi":"10.1016/j.fas.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.009","url":null,"abstract":"<p><strong>Background: </strong>Due to advances in minimally invasive surgical treatments (MIST), this systematic review with a narrative synthesis aimed to investigate the effectiveness of MIST in improving pain compared with non-surgical treatment or placebo in patients with plantar fasciopathy (PF).</p><p><strong>Methods: </strong>We systematically searched relevant databases for peer-reviewed studies comparing MIST to non-surgical treatments or placebo.</p><p><strong>Results: </strong>Eight studies were included. The results demonstrated statistically significant superiority in pain reduction for percutaneous needle treatments compared to non-surgical treatments or placebo in five studies. One study compared endoscopic plantar fascia release to exercise and corticosteroid injections and found a statistically significant superiority of endoscopic plantar fascia release.</p><p><strong>Conclusions: </strong>This systematic review found promising effects of needle treatments to reduce pain among patients with PF. Endoscopic plantar fascia release was superior to the comparator in one of three studies. High risks of bias and methodological heterogeneity limit the strength of the available evidence.</p><p><strong>Level of clinical evidence: </strong>II.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The sural nerve & the calcaneus: A radiographic and anatomical study.","authors":"Alexander M Wakker, Marisa Claassen, Michael H J Verhofstad, Theo van Walsum, Jacob J Visser, Mark G van Vledder, Hilco P Theeuwes","doi":"10.1016/j.fas.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.005","url":null,"abstract":"<p><strong>Background: </strong>The sinus tarsi approach (STA) is a commonly used minimally invasive surgical approach for the fixation of joint depression-type calcaneus fractures. As the sural nerve (SN) is particularly at risk during the STA, understanding the SN's course in relation to bony landmarks on fluoroscopic imaging is crucial.</p><p><strong>Methods: </strong>Dissection of 19 post-mortem humans were performed to expose the SN. The SN's course was mapped relative to radiographic bony landmarks, anatomical plates for fracture fixation, and the STA incision location.</p><p><strong>Results: </strong>The SN typically enters the cranial part of the calcaneus midway between the posterior talocalcaneal (PTC) joint and the calcaneal tuberosity. The posterior tail of the calcaneal plates were always placed under the main branch of the SN.</p><p><strong>Conclusion: </strong>The study highlighted that the SN is always at risk during minimally invasive plate fixation for calcaneal fractures. Intra-operative fluoroscopy could be beneficial for minimizing nerve damage and enhancing surgical outcomes.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the European Foot and Ankle Score (EFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) in patients with foot and ankle surgery.","authors":"Victoria Julia Frank, Philipp Lichte, Natalia Gutteck, Bertil Bouillon, Dariusch Arbab","doi":"10.1016/j.fas.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.008","url":null,"abstract":"<p><strong>Background: </strong>Both EFAS and AOFAS are questionnaires used in evaluating postoperative outcome of foot and ankle surgeries. The EFAS is a Patient Reported Outcome Measure (PROM), whereas the AOFAS also contains a physician reported subset and is the most commonly used questionnaire worldwide. Our study compared psychometric properties of both scores in patients with foot or ankle surgery.</p><p><strong>Methods: </strong>We compared validity and reliability of the EFAS and AOFAS questionnaires in 126 foot and ankle surgical patients. Internal consistency, test-retest reliability, floor and ceiling effects, construct validity, responsiveness and minimal important change were analyzed.</p><p><strong>Results: </strong>The AOFAS and EFAS show similar psychometric properties overall with the EFAS showing better internal consistency than the AOFAS with a smaller standard error of the mean (SEM), while the AOFAS showed a higher sensitivity to change.</p><p><strong>Conclusions: </strong>Both the EFAS and the AOFAS show comparable psychometric properties. The EFAS performs better regarding SEM and internal consistency. Furthermore EFAS is a PROM without investigator bias and should therefore be preferred.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving partial weight bearing compliance with a smart insole: Validity, reliability, and feasibility study.","authors":"Ender Ersin Avcı, Gazi Akgün, Mehmet Esat Uygur, Mine Gülden Polat, İlkşan Demirbüken","doi":"10.1016/j.fas.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.007","url":null,"abstract":"<p><strong>Background: </strong>Partial weight bearing (PWB) plays a critical role in early stages of rehabilitation following lower-extremity orthopedic surgery. However, it has been reported patients often have difficulty complying with PWB restrictions, particularly in home setting. The newly designed smart insole system aims to address this issue by remotely monitoring the patient's weight-bearing loads and providing real-time feedback for non-compliant weight-bearing to support PWB compliance. The aim of this study was to assess the validity and reliability of the system in measuring weight-bearing loads and to investigate its feasibility in improving PWB compliance.</p><p><strong>Methods: </strong>The research involved two phases: an experimental design to test validity and reliability in a clinical setting, and a randomized controlled design to test feasibility with remote monitoring at home. Validity and reliability were assessed on a healthy subject using simultaneous load measurements from a smart insole and a force plate under three metronome conditions (30,40, and 60bpm). In the feasibility phase, twelve patients who had undergone microfracture surgery for talar osteochondral lesions were recruited at 4 weeks postoperatively. Participants used Android smartphones and met Ferkel & Scaglione classification criteria I, IIA, and IIB. They were randomized into groups with feedback (FB) or without feedback (NFB) and their compliance with PWB limits was monitored remotely 24-hours for one week using the Insole system.</p><p><strong>Results: </strong>The insole demonstrated high reliability (SEM:1.67 N, ICC_1.1:0.97) and, excellent agreement with the force plate (R²=0.9175, p < 0.001). The FB group achieved higher compliance with prescribed PWB thresholds compared to the NFB group.</p><p><strong>Conclusions: </strong>The newly developed insole system is a valid and reliable rehabilitation tool for accurately measuring weight bearing loads. The system's ability to provide continuous remote patient monitoring and real-time feedback on non-compliant weight bearing has proven to be effective in PWB compliance, which is critical in the postoperative recovery period.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open and closed ankle fracture treatment in Japanese nonagenarians and octogenarians: Mortality, surgical site infections and readmissions.","authors":"Takahisa Ogawa, Haggai Schermann, Claude Picard, Kiyohide Fushimi, Toshitaka Yoshii","doi":"10.1016/j.fas.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Several publications have suggested that elderly patients with open ankle fractures may have grave prognosis in terms of mortality, similarly to elderly patients with hip fractures. In this study we evaluated the effect of open ankle fractures on patient mortality in elderly population, including octogenarians and nonagenarians.</p><p><strong>Methods: </strong>This retrospective cohort included all patients above the age of 60 treated in Japan public emergency care hospitals between the years 2010 and 2018. Patients with lateral malleolus, medial malleolus, bimalleolar, trimalleolar and pilon fractures were included. The outcomes were mortality, length of hospital stay, surgical site infections and readmissions within one year.</p><p><strong>Results: </strong>There was a total of 6766 patients ages above 60, of whom 6062 had closed fractures and 704 had open fractures. Open fractures were not associated with higher mortality than closed fractures. Patients with open fractures stayed in the hospital for longer time (median of 51 vs 37 days, p < 0.001), had higher rate of surgical site infections (5.3 % vs 1.7 %, p < 0.001) and a lower rate of readmissions (2.6 % vs 6.2 %, p < 0.001).</p><p><strong>Conclusion: </strong>The study shows that elderly patients with open ankle fractures are hospitalized for longer time and experience a higher rate of surgical site infections. However, they do not experience excess short-term mortality in this study setting.</p><p><strong>Level of evidence: </strong>IV (non-experimental study).</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manchester oxford foot questionnaire in foot and ankle Spanish patients: Transcultural adaption and validation.","authors":"A Gines-Cespedosa, G Gonzalez-Lucena, C Gamba, A Bailez, P Ruiz-Riquelme, J Martinez-Lozano","doi":"10.1016/j.fas.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>Manchester-Oxford Foot Questionnaire (MOXFQ) has shown the best psychometric properties to evaluate patient-related outcomes in foot and ankle(F&A) surgeries. The aim is adapting and validating the MOXFQ for European-Spanish population, while assessing its psychometric properties.</p><p><strong>Method: </strong>Translation and cross-cultural adaption (MOXFQ-EUROSpa) was performed from MOXFQ-English original test. Its psychometric properties (reliability, internal consistency, floor and ceiling effects, construct validity and responsiveness) were calculated in 102 patients operated of orthopaedic F&A surgery in a Spanish hospital between 2021 and 2022. It was applied MOXFQ-EUROSpa, VAS-pain and EURO-QoL questionnaires. Data analyzed with SPSS.13.0; p-value < 0.05 RESULTS: MOXFQ-EUROSpa showed excellent reliability (ICC=0.94 MOXFQ-index) and strong internal consistency (Cronbach's alpha=0.95 MOXFQ-index). Strong correlation with EuroQoL and VAS-pain confirmed validity. Good to excellent responsiveness for all domains, except MOXFQ-social(moderate). Postoperative MOXFQ-social had a floor effect.</p><p><strong>Conclusion: </strong>MOXFQ-EUROSpa demonstrated good psychometric properties therefore it should be considered to evaluate elective foot and ankle procedures results.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI vs SPECT-CT in the diagnosis of fracture-related talar osteochondral lesions.","authors":"J Ojeda-Jiménez, P Vilá-Vives, S Tejero, D González-Martín, D A Rendón-Díaz, S Santini, V Valderrabano, M Herrera-Pérez","doi":"10.1016/j.fas.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence of osteochondral talar lesions (OCTLs) in ankle fractures could explain the suboptimal functional outcomes in well-treated patients. The presence of OCTLs in magnetic resonance imaging (MRI) is not always related to symptoms, regardless of the existence of bone edema. On the other hand, single photon emission computed tomography (SPECT-CT) provides information on the metabolic activity and could have a better clinical-radiological correlation. The aim of the present study is to compare MRI versus SPECT-CT in terms of the clinical-radiological correlation of hidden OCTLs after ankle fractures considered arthrogenic.</p><p><strong>Methods: </strong>An ambispective study was conducted in which 40 patients who underwent ankle fracture surgery were included. They completed the AOFAS and EFAS questionnaires and underwent MRI and SPECT-CT. Functional results were compared according to the presence or absence of OCTLs in each technique and based on the existence of bone edema in MRI and radiotracer uptake in SPECT-TC.</p><p><strong>Results: </strong>The detection of OCTLs by SPECT-CT was statistically related to worse results on the AOFAS scale (p < 0.05). Radiotracer uptake on SPECT-CT was related to worse results on the AOFAS scale (p < 0.05), while this difference was not found in OCTLs where bone edema was observed on MRI.</p><p><strong>Conclusion: </strong>SPECT-CT appears to be superior to MRI in the detection of symptomatic fracture-related OCTLs. Furthermore, radiotracer uptake on SPECT-CT is associated with worse functional outcomes, being a more reliable marker than bone edema on MRI to evaluate the activity of OCTLs.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and clinical considerations of Os Vesalianum Pedis: A meta-analysis.","authors":"Aleksander Osiowski, Maciej Preinl, Maksymilian Osiowski, Katarzyna Baran, Barbara Jasiewicz, Dominik Taterra","doi":"10.1016/j.fas.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>Os vesalianum (OV) is a rare anatomical variation located at the lateral site of the foot. Although usually asymptomatic, it can occasionally be connected to painful disorders. The aim of this study was to provide a first meta-analysis establishing its prevalence with multiple subgroup analyses.</p><p><strong>Methods: </strong>Three major databases (Pubmed/Medline, Embase, ScienceDirect) were thoroughly searched for studies reporting data on the prevalence of OV up until August 2024. The relevant data regarding OV was extracted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were closely followed in this study. AQUA-tool was used to assess the quality of included studies.</p><p><strong>Results: </strong>A total of 22 studies and 21 312 feet were included in this meta-analysis. The pooled prevalence estimate (PPE) of OV was found to be 0.6 % (95 %CI: 0.4-0.9). In the female subgroup, the PPE of OV was 0.6 % (95 %CI: 0.3-1.4) and in the male group 0.5 % (95 %CI: 0.2-1.3). Os vesalianum was most common in the North American population (1.0 %, 95 %CI: 0.6-1.7), then it was equally prevalent in Europe (0.6 %, 95 %CI: 0.3-1.3) and in Asia (0.6 %, 95 %CI: 0.3-1.0). In studies that examined the prevalence of OV with an X Ray examination, the PPE was 0.6 % (95 %CI: 0.4-1.0).</p><p><strong>Conclusions: </strong>Os vesalianum is an uncommon accessory ossicle that is present in less than one in a hundred feet. In rare occasions, OV may be a cause of lateral foot pain, thus it must be differentiated with relatively more usual encounters such as fractures of fifth metatarsal bone or Iselin's disease.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of kidney function on 30 day post-operative complications and mortality following ankle fracture ORIF.","authors":"Paul Pottanat, Carson McKoon, Joshua Morningstar, Kola George, Daniel Scott, Christopher Gross","doi":"10.1016/j.fas.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.fas.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Estimated glomerular filtration rate (eGFR) is commonly used to evaluate kidney function before surgery, but research on its impact on outcomes after ankle fracture open reduction and internal fixation (ORIF) is limited. This study aims to analyze how eGFR affects short-term complications and mortality following ankle fracture ORIF.</p><p><strong>Methods: </strong>The American College of Surgeons (ACS) NSQIP database was queried from 2005 to 2019 to identify 44,755 patients who underwent ankle fracture ORIF using specific CPT codes. Patients were excluded for missing demographic data or preoperative eGFR exceeding 3 standard deviations above the mean (91.1 mL/min/1.73 m²). Patients were categorized by eGFR: end stage renal disease (ESRD) (<15 mL/min/1.73 m² [1.39 %]), severe loss of kidney function (15-30 mL/min/1.73 m² [2.32 %]), moderate loss of kidney function (30-60 mL/min/1.73 m² [15.45 %]), mild loss of kidney function (60-90 mL/min/1.73 m² [33.78 %]), normal kidney function (90-120 mL/min/1.73 m² [29.47 %]), and hyperfiltration (>120 mL/min/1.73 m² [17.57 %]). Demographics, hospital length of stay, 30-day complications, surgical site infections (SSI), Clavien-Dindo grade IV complications, readmissions, reoperations, and mortality rates were compared. The cohort was primarily female (64.5 %), with a mean age of 55.41 years (range, 16-89).</p><p><strong>Results: </strong>A total of 21,815 patients were included, with about 30 % having an eGFR of 90-120 mL/min/1.73 m², indicating \"normal\" kidney function. As eGFR decreased, patient age (p < .001), BMI (p < .001), female sex rate (p < .001), and comorbidities significantly increased. Multivariate regression analysis showed that compared to normal eGFR (>90), patients with ESRD or moderate to severe kidney loss had a significantly higher risk of complications (ESRD: OR=1.576; p = .028)(15-30: 1.978; p < .001), reoperation (ESRD: OR=1.872; p = .039)(30-60: 1.523; p = .012), and readmission (ESRD: OR=1.784; p = .013)(30-60: 1.389; p = .012).</p><p><strong>Conclusion: </strong>In patients undergoing ankle fracture ORIF, worse kidney function, as indicated by eGFR, was significantly linked to higher rates of postoperative complications, reoperation, and readmission. Surgeons and patients should take these findings into account for those with reduced kidney function.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Cohort Study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor to comment on “Prediction Model for Lower Limb Amputation in Hospitalized Diabetic Foot Patients Using Classification And Regression Trees”","authors":"C.A. Sánchez,&nbsp;E. De Vries,&nbsp;F. Gil,&nbsp;M.E. Niño","doi":"10.1016/j.fas.2025.03.006","DOIUrl":"10.1016/j.fas.2025.03.006","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"31 4","pages":"Page 374"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}